06-2367 (BLCK)e!
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application -Number:. �-06.700002367.,E
Property Address:
57270 PENINSULA LN
APN:
762-150-019- - -
Application description:
WALL/FENCE
Prooerty Zonind:
IOW DENSITY RESTDENTTAT
Application valuation:
6050
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C29 License No.: 649905
Date: Contractor:
OWNER -BUILDER DECLARATION'
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or .
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The .
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
() I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, an ho contracts for the projects with a contractorls) licensed
pursuant to the Contractors' State License w.l.
(_ 1 I am exempt under Sec. , B.&P.' reason
A le—
ate: ner:
CONSTRUCTION LENDINGG"AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPEM11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/13/06
.Owner:,
SOUTHERN HILLS DEVELOPMENT" -
78150CALLE TAMPICO
LA QUINTA, CA 92253
Contractor:
SABOR MASONRY _ 1
41625 ECLECTIC STREET, #M7,11
PALM DESERT, CA 92260
(76.0)674-0666
Lic. No.: 649905
---------------------------- L
COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate ofconsentto self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy "number are:
Carrier STATE FUND Policy Number 0016140-2006
1 certify that, in the performance of t e work for is permit is issued, I shall not employ any
person in any manner so as to b ome subj t to the rkers' compensation laws of California,
and agree that, if I should beco a subject o t ' compensation provisions of Section
3�7f00 of th bar Code, I s rthwith o ply wi h those provisions.
Da� v Applicant:
WARNING: FAILURE TO SECURE`I;�ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application. -
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit. "
2. Any permit issued as a result of this application beco s null and void if work is not commenced
within 180 days from date of issuance of such per , or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov informatio is correct. agree to comply with all
city Acnf—vcnances and state lawsrelating to buildin truction, nd h horize representatives
of thter upont above-mentioned propett o ins 'o oses.
ateature (Applicant or Ag
Application Number 06-00002367
Permit WALL/FENCE
PERMIT
Additional desc•:
Permit Fee 90.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
6050
Expiration Date 12/10/06
Qty Unit Charge Per
Extension
` BASE
FEE
45:00
- 5 nn 9 0000 T90TT BLDG,
2,001-25,000
45.00
----------------------------------------------------------------------------
Special Notes and Comments
242 L.F. 6..' GARDEN WALL, ORCO SYSTEM
Fee summary Charged
Paid Credited
Due.
Permit Fee Tota'_ 90.00
.00
.00
9".00
Plan Check Total .00
.00
.00
.00
Grand Total 90.00
.00
.00
90.00
Bin #
Permit # :l*'
Project Address: v
A. P. Number: Pitt.
Legs! Description:
Contractor:
c5Y1
Address: -4� (.p aS—
City, ST, Zip: 1--) `
Telephone: — b
State Lit. # : C
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Telephone #917 Contact Person
# Submittal
Plan Sets
Structural Cala.
Truss Cates,
Energy Cala.
Flood plain plan
Grading.piaa'
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Feu
City of La Quinta-
Building u Safety Division
P.O. Box. 1504, 78.495 Calle Tampico
La Quinta, CA 922.53 -.(760) 777-7012
Building Permit Application and Tracking Sheet
4 Owner's Name:
Sot tf19" e r l(s i -v.
Address: `r 8 S�
C:a-Q,10 i.- I c I
�lS2Z City, ST, Zip:
La
Telephone: 0 - --] ( _
1 bt 1— Project Description: f .
�2. p
#:O(v;1)
Construction .Type:
Occupancy;
Projxt type (circle one): Ncw Add'r Alter R "
eP Dcmo
Sq. Ft.: # Stories:
# Units:
1. Estimated Value of Projec
APPUCANT: DO NOT MITE -6
EtOW THIS UNE
9'd Ree'd TRACING
Plan Check subinitted
t
Total Permit ices
FEES
Amount
Item
Reviewed, readyfor corrections
Plan Check Deposit
Called Contact Person
Plan Check ):glance
Plans. Picked. up
Construction
Plans resubmitted
Mechanical
2`4 Review, ready [or eorrectlons/Issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Plans resubmitted
Grading
4d Review, ready for corrections/issue
Developer In.pact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
t
Total Permit ices
FEES
Amount